We carried out an announced inspection of Eveshel Care Limited on 1 November 2018. Eveshel Care Limited is registered to provide personal care to people in their own homes. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection, the service provided personal care to nine people in their homes.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run. At the time of the inspection the registered manager was not available.

At our last inspection on 12 January 2017 the service was rated ‘Good’ overall. We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service did not ensure that the care and support provided to people always reflected and met their needs and preferences. During this inspection we found that this previous breach had been addressed.

Staff did not always arrive on time to see people and the system in place to monitor time keeping was not always effective. We recommended the service review procedures to ensure the risk of missed visits or late calls were minimised.

Staff knew how to keep people safe from harm and how to report concerns of potential abuse. Detailed risk assessments were in place that guided staff to provide safe care and support and reduce the risk of harm. Staff were recruited in a safe manner and line with the provider’s recruitment policy, which meant we were assured staff were suitable to carry out their role. People were supported to receive medicines in line with best practice and the service ensured all staff had medicines training. People and staff were protected from the risk infection.

Staff were supported through a detailed induction and had access to ongoing training, as well as regular supervisions and an annual appraisal to ensure they could provide care in line with best practice guidance. Information was used from the local authority to ensure the service could offer the right support to people. The service worked in line with the principles of the Mental Capacity Act (2005) and staff gained consent from people before providing any care or support. People were supported to keep hydrated and have a well-balanced diet. People received support from other health and social care professionals to ensure they had a healthy lifestyle.

Relatives told us staff were kind, caring and friendly. The service involved people and their relatives in reviewing individual care plans. Staff understood how to support people in a manner that ensured people were protected from discrimination. Relatives told us that people’s privacy and dignity was maintained and staff promoted a sense of independence for all people.

Relatives told us staff knew people well and provided care that was person-centred. Each person had an individual care plan; these care plans were up to date and reflected people's support needs. Relatives told us they felt comfortable raising any issues they might have about the service and there were arrangements in place to deal with complaints. The service supported people with their end of life wishes.

People, relatives and staff felt well supported by the management team and felt the service delivered high quality support. The provider sought feedback from people and their relatives. The serviced worked positively with other health and social care professionals to ensure people received a person-centred care and support package. The quality assurance systems in place ensured staff were monito

The inspection took place on 12 and 13 January 2017 and was announced. The service had not been inspected since it first registered in 2014. It changed its name and registration in September 2016.

Eveshel Care, also known as Sure Care (Havering), provides personal care to people in the London borough of Havering. On the day of our visit there were seven people using the service but this number fluctuated up to 20 regularly as the service was currently providing end of life and palliative care packages.

The service did not have a registered manager. However, a manager had been employed and was in the process of registering with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There was a shortfall in the systems in place to review care plans and ensure that staff stayed for the contracted visit times. People, their relatives and records we reviewed confirmed that people did not always receive care for the contacted time. This impacted on their individual preferences as some aspects of care were either missed out or not completed in accordance with people’s preferences.

People told us they felt safe and trusted the staff that looked after them. They were supported by staff who were aware of the procedures to protect them from abuse. Staff were enabled to support people effectively by means of supervision, training, appraisal and regular spot checks.

People told us that they were supported to eat and drink sufficient amounts according to their tastes and preferences. Staff were aware of the procedures in place to refer people to other healthcare professionals when required.

Staff were aware of the procedures to follow to ensure that medicines were handled safely. Risks to people and the environment were regularly assessed in order to protect people from avoidable harm.

There were robust recruitment checks that included the necessary criminal checks to ensure that staff were suitable to work in the health and social care environment.

The service ensured that there were enough staff available to cover for emergency, absences and other leave in order to ensure that there were no missed visits.

Staff demonstrated an understanding of how they would obtain consent to care. They had an awareness of how the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLs) applied in practice.

People told us that they were treated with dignity and respect and that their wishes were respected. They were aware of how to make a complaint and thought that their complaint would be listened to and resolved by the registered manager.

Quality checks were completed by the managers in order to monitor and improve the quality of care delivered.

The service had a positive culture that was open and inclusive. People and staff thought the management team were approachable and open to suggestions made in order to improve the quality of care delivered.